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Validation
of neuroradiologic response assessment in gliomas: RECIST (1D) vs 2D
measurements vs computer-assisted tumor area vs volume
E.
Galanis, M. J. Maurer, K. V. Ballman, J. O'Fallon, R. Sykora, R. Castillo, J. C.
Buckner, B. J. Erickson
for
the North Central Cancer Treatment Group; Mayo Clinic, Rochester, MN; Ochsner
Cancer Institute, New Orleans, LA
Background.
There are significant limitations associated with use of standard radiographic
measurements as indicators of response in glioma therapy trials.
The RECIST criteria were recently introduced in an attempt to standardize and
simplify assessment of response to treatment in cancer clinical trials.
However, their applicability in gliomas has only been assessed in a very small
number of pts (JNCI, 92(3):205).
Purpose.
To validate radiographic response assessment in newly-diagnosed glioma pts.
Methods.
73 Mayo Clinic pts participating in 9 NCCTG prospective trials for newly
diagnosed gliomas were included; 614 MRI scans were analyzed.
All scans were performed using the same technique [5 mm thick slices with 2.5 mm
gap, with pre- and post gadolinium (GAD) contrast T1-, conventional spin-echo
proton-density and T2 weighed images], and were "de-identified" to
random numbers.
Kaplan-Meier survival curves for responders/non-responders were compared with
logrank test for each method.
Results.
P-values of associations among measures of response and survival are given in
the table.
There was no significant survival difference between pts classified as
responders (or non-responders) by RECIST 1D vs 2D measurements for either GAD or
T2 images (all p values >0.17 by permutation analysis).
Conclusions.
Tumor responses as assessed by RECIST or 2D measurements in GAD enhanced images
are associated with survival improvement, and there is no evidence that either
method is superior.
Additional comparisons with computer assessed T2 tumor area and volume, which
are also associated with survival, are in progress and will be presented.
|
Measurement
|
Responder 2 yr Survival (95% CI)
|
Non-Responder
2 yr Survival (95% CI)
|
Logrank p-value
|
|
1D-T2
|
63.2
(44.8, 89.0)
|
62.5
(50.2, 77.8)
|
0.305
|
|
2D-T2
|
70.0
(52.5, 93.3)
|
59.6
(47.1, 75.4)
|
0.818
|
|
AREA-T2
|
88.9
(75.5, 100.0)
|
53.1
(40.8, 69.0)
|
0.020
|
|
VOLUME-T2
|
83.3
(64.7, 100.0)
|
58.2
(46.5, 72.8)
|
0.035
|
|
1D-GAD
|
68.8
(49.4, 95.7)
|
30.0
(15.4, 58.6)
|
0.038
|
|
2D-GAD
|
68.8
(49.4, 95.7)
|
30.0
(15.4, 58.6)
|
0.002
|
|
AREA-GAD
|
64.3
(43.5, 95.0)
|
36.3
(20.9, 63.2)
|
0.270
|
|
VOLUME-GAD
|
54.5
(31.8, 93.6)
|
44.0
(28.3, 68.5)
|
0.897
|
© Copyright 2003
American Society of Clinical Oncology All rights
reserved worldwide
Source: http://www.asco.org/ac/1,1003,_12-002489-00_18-002003-00_19-00101990-00_29-00A,00.asp?cat=CNS+Tumors&parent=
Central+Nervous+System+Tumors&returnpid=2325&SubCat_ID=4
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